A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...

Board of Directors Part 114 June 2013However, there is a need and understanding that nursing staff haveto show flexibility and may occasionally need to change wardswhere an acute problem arises.Some wards reported that band 5 nurses were not prepared toperform more basic tasks, leaving this to HCAs, even when theHCAs were under pressure, which is not good team work.When we asked whether there was ever a time when there was noregistered nurse on the ward, all wards replied that at least one registerednurse is always allocated to every ward at night. Only one member of stafffrom Ward 22 and one from the Stroke Unit said that for very shortperiods, such as toilet breaks, might there not be a registered member ofstaff on the ward at all times.7.3.3 Support and help from the Clinical Site Team (CST)There were high levels of satisfaction for the help and support given by theCST. Answers for a timely response from the CST were also very positivebut some dissatisfaction was aired on a couple of wards.If the CST was under pressure and pushed, wards suffered. It wasgenerally felt that the CST could do with another member of staff, whichcould be the same as the twilight/roving band 5 or 6 previously mentioned.There is usually no dissatisfaction with the time taken for red alert calls tobe answered by the CST and doctor but nursing staff felt that amber callscould take a long time for a doctor to respond.Medical staff were a cause of repeated comment by most wards.Generally in this very busy admission period staff complained that it wasdifficult to get hold of a doctor and they often took far too long to come towards particularly for writing up drugs and intravenous regimes. Mostnursing staff felt there should be another doctor on for the wards at nightpreferably someone more senior. There were some comments that doctorresponse and answering bleeps was particularly bad at the night doctorhandover at 23.00.It is difficult to know what the doctor response times were when thehospital was less busy prior to September but since this increase inadmissions has continued for over six months one may have to concludethat this is the new norm and it would seem there is a strong universalfeeling amongst nursing staff and the CST that current levels of medicalcover are inadequate.Only one third of nursing staff felt there was adequate support for themwhen their ward was under pressure. How often this happens and if thereis any pattern of cause or failure of response was not ascertained.11The Hospital at NightQuality/Performance